Pub and Cafe facilities on the Dementia wards – Lancashire Care

The staff from Wordworth and Bronte dementia wards designed a bar and café within their ward garden, a place for their patients and families to sit and spend time together reminiscing and enjoying their refreshments i.e. non alcoholic beers, crisps, tea, cake and cloudy lemonade with help and support from local people and services who donated equipment.

Co-Production

From start: Yes

During process: Yes

In evaluation: Yes

Evaluation

Peer: No

Academic: No

PP Collaborative: Yes

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What We Did

Wordsworth and Bronte ward are purpose built dementia wards based at the Harbour in Blackpool. Patient meetings were held and we had discussion forums of what patients wanted on the ward to make their stay in hospital more comfortable and improve their experience. We also involved carers/relatives when they were on the ward. Following these patient/relative discussions, we discussed in team meetings with the ward staff to involve them and build on idea’s already received. We also shared the reasons why a pub and café would be beneficial for our patient group, discussing reminiscence and distraction. We also discussed social norms and researched pubs in the 1950’s/60’s to ensure that the pub was as authentic as possible and that there were enough objects in there to stimulate conversations and happy memories. Together, everyone was very enthusiastic and shared idea’s. The staff and relatives contributed by collecting items to decorate the pub. Some of these included beer pumps, bar mats, pictures, optics, a bell to ring last orders, ornaments. Several patients expressed that they enjoyed going to the pub and ‘propping up the bar’. They expressed that it was a social activity that they did before coming to hospital or when they were younger. To put the idea’s in to practice, we put an idea board together of what we wanted and presented this to senior management to achieve the funding for our project. We also coincided our project with Dementia Awareness week. We agreed an opening day, inviting senior management and the CEO, patient families and the Alzheimer’s society. We advertised Dementia awareness week and the opening of the pub and café via posters and the media. During Dementia awareness week we held several activities to raise money and awareness whilst supporting relatives. One activity was to donate a small amount of money to write a name for the pub and café. When these were picked, the most popular name for the pub was after a former patient who staff had nursed for a long time and were very fond of. The café also chose a former patient to name the café after and her husband was asked to officially open the café. Ward managers from both wards were interviewed by Lancashire Life and this was televised and shared on social media. The response was very positive and publicity was wide spread with people contacting us asking for advice as they are going to open something similar at the care homes they worked in. The pub was used to de-escalate and distract patients who were agitated or distressed. An example of this was one patient who had had a particularly unsettled week with long periods of agitation and wandersome behaviour. Once the patient was introduced to the pub he was observed to be smiling, engaging with others, dancing to the music, ordering drinks for people. Another example is when relatives visited they were able to sit outside of the pub in the ‘beer garden’ with their relatives and they expressed that this felt ‘normal’ and an activity they used to enjoy together. An example of the café having a positive effect on patients was a lady who used to be a cleaner. When the café was opened she enjoyed ‘working’ at the café, cleaning the tables and tidying away cups. This improved her mental health by giving her a sense of purpose and kept her occupied during the day, staving off fears and anxieties that she had been displaying.

Wider Active Support

We worked closely with the Alzheimer’s society to demonstrate why this project would benefit our patients and carers during their stay on the wards. They support the idea and helped along the way with fund raising and the links to positive outcomes for people with dementia. We have had Blackpool Victoria, Calderdale and Huddersfield, and Humber NHS trusts visit the wards to take the ideas of the pub/café and replicate on their dementia services.

Co-Production

We used a co- production model using current patients and carers as leaders in the design and construction of the pub and café. Patient meetings and forums were held to keep the momentum going on the ideas and then we continue to collect feedback on the use of the pub and café. The patients, their families, friends and staff have been involved in this project from it beginning to its opening. Staff have worked hard on the development of the bar and café. The words I have heard in these early days of this project from the patients, their families and staff is proud, fabulous, great place to be, just what we needed, Nothing but positivity. Both the bar and café have been named after former patients.

Looking Back/Challenges Faced

On reflection we would have designed the pub and cafe inside the ward rather than in the garden as this would have enabled us to use the facility throughout the whole year, as opposed to it very much being dependent on weather. We overcome this by making the most of it when the weather is suitable.

Sustainability

All members of the team are involved, not just those who have led the project. Everyone is committed to ensuring this project continues to thrive. The facility is in place and it just requires the motivation of staff and patients to use it well, this has happened and the pride that the services have in this occupational activity is amazing to see….you can see that all they want to do is make life enjoyable for patients and to ensure that there is sufficient stimulation for them whilst experiencing care with us. FFT feedback and patient/carers meetings have comments about the cafe and pub in a very positive light, especially when linking to family time/visiting time which is very important in patients and their loved ones wellbeing.

Evaluation (Peer or Academic)

No formal evaluation however lots of positive feedback received. We have also completed environment audits and the pub and café have significantly improved the environment, making it more dementia friendly. As part of FFT feedback we have received compliments about both the café and the Pub, patients relatives bring their dogs in to see their owners whilst they are in hospital with somewhere conducive and stimulating to sit and visit.

We will be assessed through Dementia care mapping as part of dementia awareness week

Outcomes

Staff have fed back that they enjoy spending more 1:1 time in a more social environment. Nobody is excluded as leave isn’t required as it is on ward grounds. It has improved relationships between the dementia wards as we have held joint events, working as one team, for example on Remembrance day both wards held an event together and the Pub was a clear part of the celebrations. Staff morale has improved as they were involved from the beginning, painting the pub and café and contributing in whatever way they could. It has also helped when staff have been re-deployed to the opposite dementia ward as they are more familiar with colleagues and patients.

Sharing

We have a big twitter community and have shared this service widely – having very positive messages from Fab academy, NHSE and other providers who have visited. One of the Ward sisters has presented at a Network event to share practice across the Trust.

Is there any other information you would like to add?

We are having a first birthday party for the pub and cafe during dementia awareness week 2017. We will be inviting relatives, colleagues, Alzheimer’s society. We continue to improve our environment for people with dementia and are nearly ready to be assessed by the Dementia Action Alliance

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This site is supported by the Positive Practice in MH Collaborative, Breakthrough MH Ltd, the National Collaborating Centre for Mental Health and Otsuka Health Solutions